Lake Harvey Association
Membership Dues & Donations
First Name:
Last Name:
Phone Number:
Phone Number:
Cell Phone
Address:
Email:
Membership Dues $25.00
State
City:
Zip
Annual Renewal
New Member
Donations Only
What Can We Do For You?
I am a town of Barnet resident
Summer Address
Mail My Annual Newsletter
Mail & Email My Newsletter
Email My Newsletter
Address:
Annual Newsletter Delivery
Additional Donation
City:
State:
Zip:
Lake Preservation donors of $100 or more
are eligible for a plush Lake Harvey Loon
(squeeze for official Audubon Society
Winter Address
loon call!) as a token of our gratitude.
Yes Ship a Loon
Fireworks
Lake Summer Picture
Current Total:
Lake Preservation:
Lake Winter Picture
Purchase Raffle Ticket
$5.00 each
Stained Glass Lake & Mountain
Lake Harvey Donations
Lake Harvey Cards 10pk
Amount & Payment
Plus $4.00 S&H
N o t e
I grant permission to publish my/our name(s) as LHA member(s) and contributor(s).
5/9/24